Behavioral Health Utilization Review Nurse URNR#01
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Job Location:
Phoenix, NM - USA
Hourly Salary:
$ 32 - 34
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Job Title: Behavioral Health Utilization Review (UR) Nurse
Location: Phoenix AZ
Job Type: Contract
Schedule: MondayFriday 8:00 AM 5:00 PM
Pay Rate: $32$34 per hour
Work Arrangement: 100% Remote (initial onsite visit required to receive equipment)
Position Summary
Navitas Healthcare LLC is seeking an experienced Behavioral Health Utilization Review (UR) Nurse to support monitoring compliance and quality oversight for Fee-for-Service (FFS) and Serious Mental Illness (SMI) member populations. This role focuses on ensuring contractual regulatory and statutory compliance for physical/acute care services and behavioral health needs.
The UR Nurse will analyze utilization trends conduct clinical reviews and audits and collaborate with internal and external stakeholders to support medically necessary covered services.
Key Responsibilities
Monitor overutilization and underutilization of services
Conduct utilization reviews case file reviews and clinical audits
Provide oversight guidance and technical assistance related to care delivery
Gather organize analyze and evaluate data from multiple sources including utilization reports and medical records
Coordinate care with interdisciplinary teams and external partners
Make referrals as appropriate to support member care needs
Participate in clinical staffing and case discussions as needed
Serve as a clinical resource regarding medically necessary covered services
Required Qualifications
Bachelor of Science in Nursing (BSN)
Minimum of 2 years of experience as a Registered Nurse
At least 1 year of experience in Behavioral Health
Active Registered Nurse (RN) license in the required state
FPCC certification (or equivalent as applicable)
For more details contact at or Call / Text at .
About Navitas Healthcare LLC certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.
Required Experience:
IC
Key Skills
- Environmental Safety
- Lotus Notes
- Bank Reconciliation
- ITIL
- E-Commerce
